title: Urothelial effects of oral agents for overactive bladder.
abstract: The cholinergic system of the bladder includes muscarinic receptors distributed to detrusor myocytes and structures within mucosa including bladder afferent (sensory) nerves. The receptors have been shown to be involved in afferent signaling from the bladder, but it has not been established to what extent effects on this mucosal signaling pathway contribute to the therapeutic efficacy of the clinically used antimuscarinics. Mucosa can be influenced by antimuscarinics via the bloodstream. However, some antimuscarinics and their active metabolites are excreted in urine in amounts that may affect the mucosal muscarinic receptors from the luminal side. This has not yet been demonstrated to imply superior clinical efficacy. Nevertheless, mucosal afferent signaling pathways are therapeutically interesting targets that should be further explored.
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. keanders@wfubmc.edu
authors.forename: Karl-Erik
authors.initials: KE
authors.lastname: Andersson
authors.forename: Claudius
authors.initials: C
authors.lastname: Fullhase
authors.forename: Roberto
authors.initials: R
authors.lastname: Soler
mesh_terms: D000284:Administration, Oral; D006801:Humans; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D019459:Urothelium / Q000187:drug effects
chemical_list: D018727:Muscarinic Antagonists